Salaffi Fausto, Carotti Marina, Grassi Walter
Department of Rheumatology, Ospedale A. Murri, University of Ancona, Via dei Colli, 52, 60035 Jesi (AN), Italy.
Clin Rheumatol. 2005 Feb;24(1):29-37. doi: 10.1007/s10067-004-0965-9. Epub 2004 Jul 17.
Health-related quality of life (HRQL) assessment is receiving increased attention as an outcome measure in osteoarthritis (OA). The aims of the study were to assess the health status impact of hip and knee OA in the general older population and to compare the metric properties of the WOMAC disease-specific questionnaire (Western Ontario and McMaster Universities) with generic measures [i.e., the Short Form 36 (SF-36) in patients with OA of the lower extremities]. This cross-sectional survey included a total of 244 patients (99 male, 145 female), aged 50 years and over, with symptomatic OA of the hips (107 patients) and knees (137 patients). All patients completed the WOMAC and the SF-36 questionnaires and were assessed for radiographic damage and for the presence of specific comorbid conditions. The overall impact on health was substantial for both groups of patients with OA of the lower extremities. The most striking impact was seen in OA of the hip for SF-36 "physical function" (p=0.03) and "physical role" (p=0.04), as well as WOMAC "physical function" (p=0.001). Furthermore, impairment of HRQL was only weakly associated with increasing radiographic changes. The SF-36 overall scores showed a better gradient with comorbidities than the WOMAC. This investigation has confirmed that WOMAC is the instrument of choice for evaluating patients with lower limb OA. For a more general insight into patient's health and in particular cross-sectional studies of the elderly, where comorbidity is common, the SF-36 should also be used. This study also provides an estimate of the impact of OA of the hip and knee on HRQL.
作为骨关节炎（OA）的一项结局指标，与健康相关的生活质量（HRQL）评估正受到越来越多的关注。本研究的目的是评估髋部和膝部OA对一般老年人群健康状况的影响，并比较WOMAC疾病特异性问卷（西安大略和麦克马斯特大学问卷）与通用量表[即下肢OA患者的简明健康状况调查量表（SF-36）]的测量特性。这项横断面调查共纳入了244例患者（男性99例，女性145例），年龄在50岁及以上，患有有症状的髋部OA（107例患者）和膝部OA（137例患者）。所有患者均完成了WOMAC和SF-36问卷，并接受了影像学损伤评估以及特定合并症的检查。两组下肢OA患者对健康的总体影响都很大。在SF-36的“身体功能”（p=0.03）和“身体角色”（p=0.04）以及WOMAC的“身体功能”（p=0.001）方面，髋部OA的影响最为显著。此外，HRQL受损与影像学改变增加仅存在微弱关联。SF-36的总体评分在合并症方面显示出比WOMAC更好的梯度。这项调查证实，WOMAC是评估下肢OA患者的首选工具。为了更全面地了解患者的健康状况，特别是在合并症常见的老年人群横断面研究中，也应使用SF-36。本研究还提供了髋部和膝部OA对HRQL影响的估计值。
